TITLE:
Treatment of Children with Anorectal Malformations—10-Year Review
AUTHORS:
Sejdi Statovci, Hysen Heta, Nexhmi Hyseni, Salih Grajçevci, Murat Berisha, Gani Çeku
KEYWORDS:
Anorectal Malformations, Anal Stenosis, Colostomy, Bowel Management, Children
JOURNAL NAME:
Open Access Library Journal,
Vol.2 No.3,
March
16,
2015
ABSTRACT:
Introduction: Anorectal malformations include a wide spectrum of
congenital defects of the anus, anal canal and rectum, which are often combined
with urogenital tract defects. They are often associated with congenital anomalies
of other organ systems such as genitourinary, cardiovascular, digestive,
skeletal, etc. Objectives: This study aimed to review the patients with
anorectal malformations, diagnosis,
different types of associated anomalies and their frequency, modalities of treatment,
results of treatment and complications. Materials and Methods: Since 2010, we have
performed a combined retrospective and prospective analysis of a total of 76
patients with anorectal malformations which were diagnosed and treated at our
clinic between 2005 and 2014. Results: Of 76 patients with anorectal malformations, 48 were male
(63.16%) and 28 female (36.84%). Anal stenosis was the commonest type (30.26%)
followed by ARM without fistula (25.00%) and rectourethral fistula (18.42%).
The most common associated anomalies were urogenital (49.12%), cardiovascular
(21.05%), gastrointestinal (15.79%), and bone malformations (5.26%). 34 patients
(44.74%) were treated primarily without colostomy. In 40 patients (52.63%) colostomy
was performed after birth. PSARP was the
procedure of choice in 76.92% of patients. 7 patients (9.21%) died in
total. Constipation was present in 52.38% of all patients. Patients older than
3 years of age totally continent were 30.91%. Redo operations were performed in
5 patients (7.94%). Conclusion: Early diagnosis of anorectal malformations is
very important. Some malformations such as anal stenosis are sometimes
diagnosed beyond the neonatal age. Challenging problem still remains high
percentage of children that suffer from fecal incontinence and constipation.